Transfusing from parents

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Offline Manal

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Transfusing from parents
« on: February 12, 2009, 09:40:04 PM »
I know that transfusing from parents is not advisible when there is a chance that the patient will go through BMT. But if this is not an option, does this reduce the chances of forming antibodies provided that the cross match between the father and the child is okay?? Andy and Sharmin your are experts in antibodies

manal

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Offline jade

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Re: Transfusing from parents
« Reply #1 on: February 14, 2009, 01:21:02 AM »
Hi MAnal

I also want to know that.  Does anyone have an idea?  In case of emergency  e.g. when no blood is available, if parent and child are of same blood group, can the parent donate his blood? or is it because the parent will be minor that the blood won't be good enough?

Jade

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Offline Andy Battaglia

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Re: Transfusing from parents
« Reply #2 on: February 14, 2009, 02:28:08 AM »
Yes, relatives can donate blood as long as it is a match. It is no safer to do so, and often costs more to do, but it is possible.
Andy

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Offline nice friend

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Re: Transfusing from parents
« Reply #3 on: February 14, 2009, 04:33:53 AM »
Hi buddies ,
Quote
Yes, relatives can donate blood as long as it is a match. It is no safer to do so, and often costs more to do, but it is possible
in addition , my uncles ( my father's bros ) donate's blood when-ever it needed .when-ever my thal center's admin call for blood ... their blood don't match to my group but Admin call's them in shortage times ...

Umair
Sometimes , God breaks our spirit to save our soul.
Sometimes , He breaks our heart to make us whole.
Sometimes , He sends us pain so we can be stronger.
Sometimes , He sends us failure so we can be humble.
Sometimes , He sends us illness so we can take better care of our selves.
Sometimes , He takes everything away from us so we can learn the value of everything we have.

===========
Umair

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Offline Dori

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Re: Transfusing from parents
« Reply #4 on: February 14, 2009, 09:23:50 AM »
My dad has given his blood to me in the past. I know about the bmt, but there was an other reasion that we had to stop with that. It is against the laws of donating blood in the Netherlands. Being a donor here is pure volunteer work. You dont get anything benefit for being a donor.  I know it is completely different in USA and Poland. Though I prefer our system. Btw my mother will restart given blood very soon and I am trying to convince her of being a bm donor.  :)

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Offline Manal

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Re: Transfusing from parents
« Reply #5 on: February 14, 2009, 12:11:15 PM »
Thank you all for your replies

Andy, i don't mean the safety. But rather having donors from the same family, does this help in avoiding formation of antibodies in the patient's system ( i am talking about intermedias here who may not need regular transfusion).

Many centers don't do the genotyping test, could this be a way to eliminate antibodies problem or it is the same risk as transfusing from unrelated donors. Hope you get my point

manal

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Offline Sharmin

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Re: Transfusing from parents
« Reply #6 on: February 14, 2009, 04:41:01 PM »
Manal,

My understanding is that receiving blood that is closer in the community reduces your risk of producing antibodies - therefore receiving blood from a family member may decrease that risk further.  The body is more likely to recognize blood from a family member as "own" because it recognizes it.    Directed blood donation is not allowed here either - as Dore mentioned. 

The risk of antibodies, is probably much lower - the one thing we must remember is that a child receives genes from both parents and neither parent passes on all of their genes - therefore there may be antigens that may not match up - possibly exposing the patient to antibodies - which may or may not cause antibodies at some point.    Sorry, Manal - my answer isn't clear -  but to be honest I don't think that there is a clear answer to this question.

When my son was diagnosed, I also wanted him to receive blood from myself or my husband - but we have different blood types than him. 

Sharmin
Sharmin

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Offline Andy Battaglia

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Re: Transfusing from parents
« Reply #7 on: February 15, 2009, 12:10:47 AM »
This is an interesting issue and I believe that there has been some intentional efforts to discourage this practice, based solely on administrative concerns. While directed donations from a relative may not be any safer than random blood from the community, what Sharmin said about the blood being more suitable based on the fact that it is from the same ethnic background does have validity. In addition, if you know the source, you can be 100% sure that there is no chance that the blood may carry HIV or hepatitis and this cannot be said for random blood, which even with testing there is still a minuscule chance of of contracting these diseases.

http://xpedio02.childrensmn.org/stellent/groups/public/@Manuals/@PFS/@TestProc/documents/PolicyReferenceProcedure/018778.pdf

Quote
Average risk for each unit of blood
transfused:
• rash, hives, itching: 1 in 70
• fever:
- 1 in 100 (red cells)
- 1 in 50 (platelets)
• hemolysis (breakdown of red blood
cells): 1 in 38,000 to 70,000
• hepatitis C: 1 in 1 million
• hepatitis B: 1 in 147,000
(Hepatitis B can be prevented by getting
the hepatitis B vaccine.)
• HIV (the AIDS virus): 1 in 2 million
• bacterial contamination (infection):
- less than 1 in 10,000 platelet
transfusions
- 1 in 1,000 red blood cell transfusions
(1 in 10 million are fatal)
• cytomegalovirus: by removing the white
blood cells (leukoreduction) from the red
blood cell and platelet units, we lower
the risk of cytomegalovirus transmission
and prevent recurrent, nonhemolytic
transfusion reactions

For many years there was concern that transfusions from a relative may not be safe but that has long been proven to be false.

http://www.uptodate.com/patients/content/topic.do?topicKey=~55oyXqRIqlCWeA

Quote
Last literature review version 16.3:  October 2008  |  This topic last updated:  September 23, 2003   (More)

INTRODUCTION — Prior to 1983, recipient-specific donations were considered medically indicated in a limited number of clinical situations. These included pre-renal transplant sensitization regimens; HLA-matched or family member apheresis-harvested platelet concentrates for refractory, thrombocytopenic patients; and washed maternal platelets for infants with isoimmune neonatal thrombocytopenia. In direct response to concerns about blood safety raised by the AIDS epidemic, directed donations increased dramatically after l985, despite official discouragement by all of the major blood banking organizations. Currently, directed donations constitute roughly one to two percent of all blood collected, a figure which seems to be stable.

SAFETY OF DIRECTED BLOOD — Much of the early reluctance to provide directed donations, which centered around administrative and logistical concerns, has been overcome as directed donation programs are now no more complex to administer than are autologous transfusion programs. More substantive concerns about the relative safety of directed donor blood as compared to community, volunteer blood are now addressable with data accumulated by the Retrovirus Epidemiology Donor Studies (REDS) [1]. These data were collected at five geographically and demographically diverse blood centers under the sponsorship of the National Heart, Lung, and Blood Institute of the National Institutes of Health. Seropositivity for various infectious disease markers was measured in 30,778 first-time directed donors and compared to 384,276 first-time (allogeneic) community donors:

    * There were no significant differences in the prevalence of three of the five markers — anti-HIV-1 and HIV-2, anti-HCV, and a serologic test for syphilis (STS).

    * Director donors had a significantly higher prevalence of positive tests for anti-HTLV-I (relative risk 2.32) and HBsAg (relative risk 1.99).

Further analysis of the REDS data indicated that essentially all differences between directed and community donors were explained by differences in the demographics of the two groups (age, sex, ethnic group, etc). The authors concluded that directed donors were no less safe simply because they were donating specifically for a friend or relative. Previous data, comparing the prevalence of positive tests in directed donors (60 to 70 percent of whom were first-time donors) to community, volunteer donors (a much lower percentage of whom were first-time donors), were flawed because of the incomparability of the two groups.

In summary, blood from directed donors is neither safer nor measurably less safe than blood from community, volunteer donors. Furthermore, there is an increased administrative cost associated with this procedure. As a result, we do not generally recommend directed donation.

Directed donation and pregnancy — It is probably true that some directed donors are safer than community donors, particularly spouses. However, it is prudent to avoid using a husband's blood for his wife if she is capable of and desirous of bearing children. In this setting, the wife may become sensitized to the husband's red cell antigens, possibly leading to hemolytic disease in the newborn if the fetus and father have red cell antigens lacking in the mother.

If you read the section in bold, you come away with the feeling that it is administrative reasons why this practice is discouraged. I think many of you understand this first hand with other issues and often with this issue of finding the right blood. It is not that it's impossible, but it causes more work for the staff. This is sad but it is the real state of affairs. Your doctor may feel one way but the cooperation of the hospital safe is required to implement anything. When my first child was born, one nurse pushed hard for a c-section so that she could get off her shift on time. We declined. I know hospital staff works hard and blah blah blah, but when it is the health and safety of your loved one at risk, we have to push the staff to do what is right. Stand firm and insist. They will push you around if you allow them. Your children depend on you and you have a duty to provide the best care, so don't let decisions be based on what is easiest for hospital staff.

Andy

All we are saying is give thals a chance.

 

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